Intervention Review

Limited (information only) patient education programs for adults with asthma

  1. Peter G Gibson1,*,
  2. Heather Powell2,
  3. Amanda Wilson3,
  4. Michael J Hensley4,
  5. Michael J Abramson5,
  6. Adrian Bauman6,
  7. E. Haydn Walters7,
  8. Jennifer JL Roberts8

Editorial Group: Cochrane Airways Group

Published Online: 21 JAN 2002

Assessed as up-to-date: 2 SEP 2001

DOI: 10.1002/14651858.CD001005


How to Cite

Gibson PG, Powell H, Wilson A, Hensley MJ, Abramson MJ, Bauman A, Walters EH, Roberts JJL. Limited (information only) patient education programs for adults with asthma. Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD001005. DOI: 10.1002/14651858.CD001005.

Author Information

  1. 1

    John Hunter Hospital, Department of Respiratory and Sleep Medicine, Hunter Mail Centre, NSW, Australia

  2. 2

    John Hunter Hospital, Department of Respiratory & Sleep Medicine, Hunter Region Mail Centre, NSW, Australia

  3. 3

    Unviersity of Newcastle, Newcastle , New South Wales , Australia

  4. 4

    The University of Newcastle, Discipline of Medicine, Locked Bag 1, Hunter Region Mail Centre, Australia

  5. 5

    Monash University, Epidemiology & Preventive Medicine, Melbourne, Victoria, Australia

  6. 6

    Health Services Building, Epidemiology Unit Level 4, Liverpool, Australia

  7. 7

    University of Tasmania Medical School, Discipline of Medicine, Hobart, Tasmania, Australia

  8. 8

    ACT, Australia

*Peter G Gibson, Department of Respiratory and Sleep Medicine, John Hunter Hospital, Locked Bag 1, Hunter Mail Centre, NSW, 2310, Australia. Peter.Gibson@hnehealth.nsw.gov.au.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2002

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been conducted to measure the effectiveness of asthma education programmes. These programmes improve patient knowledge, but their impact on health outcomes is less well established. At its simplest level, education is limited to the transfer of information about asthma, its causes and its treatment. This review focused on the effects of limited asthma education.

Objectives

The objective of this review was to assess the effects of limited (i.e. information only) asthma education on health outcomes in adults with asthma.

Search methods

We searched the Cochrane Airways Group trials register and reference lists of articles.

Selection criteria

Randomised and controlled trials of individual asthma education involving information transfer only in adults over 16 years of age.

Data collection and analysis

Trial quality was assessed and two reviewers extracted data independently. Study authors were contacted for missing information.

Main results

Twelve trials were included. They were of variable quality. Limited asthma education did not reduce hospitalisation for asthma (weighted mean difference -0.03 average hospitalisations per person per year, 95% confidence interval -0.09 to 0.03). There was no significant effect on doctor visits, lung function and medication use. The effects on asthma symptoms were variable. There was no reduction in days lost from normal activity, but in two studies, perceived asthma symptoms did improve after limited asthma education (odds ratio 0.44, 95% confidence interval 0.26 to 0.74). In one study, limited asthma education was associated with reduced emergency department visits (reduction of -2.76 average visits per person per year, 95% confidence interval -4.34 to 1.18).

Authors' conclusions

Use of limited asthma education as it has been practiced does not appear to improve health outcomes in adults with asthma although perceived symptoms may improve. Provision of information in the emergency department may be effective, but this needs to be confirmed.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Limited (information only) patient education programs for adults with asthma

Using a systematic approach, the medical literature was searched thoroughly to find reliable studies that looked at the effects of improving patients' knowledge about asthma, but which did not attempt to improve practical self-management skills. The results of the studies were combined to see if patient education designed to improve patient knowledge about their condition made a difference to their asthma. Improving patient knowledge alone does not seem to reduce hospitalisations, doctor visits or medication use for asthma, but may play a role in improving patients perceptions of their symptoms. However, education programmes designed to improve knowledge alone may reduce Emergency Room visits in high-risk adults.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

針對成人氣喘的有限(僅有資訊)病人教育計畫

許多氣喘管理指引的一個關鍵組成部分是對病人教育和定期醫療回診的建議。許多的對照試驗已進行了量測氣喘教育方案的效率。這些方案改善病人的知識,但對其健康成果的影響則不太明確。在最簡單的層級,教育僅限於轉換氣喘的訊息,及其原因和治療方法。本次審查重點是有限的氣喘教育所造成的影響。

目標

在這次審查的目標是評估有限的(如只提供訊息)氣喘教育對氣喘成人健康成果的影響。

搜尋策略

我們搜尋了the Cochrane Airways Group trials register及文獻的參考書目。

選擇標準

納入的文獻,為對超過16歲的成人病患,施行僅包含訊息傳遞的個人氣喘教育之隨機對照試驗。

資料收集與分析

進行了試驗品質的評估及兩名審查員獨立的分析了數據。聯繫了研究的作者以獲得遺漏的訊息。

主要結論

此次審查共納入12個試驗。其品質參差不齊。有限度的氣喘教育並沒有降低入院治療氣喘的比率(加權平均差−0.03每人每年平均住院天數,95%信賴區間 −0.09到0.03)。對於就醫,肺功能和藥物的使用並沒有顯著的影響。對於氣喘症狀的影響則很多樣性。正常活動的天數沒有減少。但在兩項研究中,認為有限度的氣喘教育並沒有改善氣喘症狀,(odds ratio 0.44,95%信賴區間 0.26至0.74)。在一項研究中,有限度的氣喘教育與減少急診的比率有關(每人每年平均減少2.76次的急診次數,95%信賴區間 −4.34到1.18)。

作者結論

雖然被認為有可能會改善症狀,但使用有限度氣喘教育已經被認知為似乎並沒有改善成人氣喘症狀的效用。於急診室提供相關的訊息可能是有效的,但仍需要進一步證實。

翻譯人

本摘要由臺北醫學大學萬芳醫院劉怡敏翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

增進病人的知識並不足以減少住院治療、醫生訪問或使用藥物治療氣喘的比率,但可能可以發揮提高讓患者認識其症狀的能力。使用系統性的搜尋方法,徹底搜索了醫學文獻以尋找可靠的研究,觀察提升病人對氣喘認知的效果,但並沒有試圖改善實際的氣喘自我管理能力。結合了所有研究的結果來觀察,假使對病人的教育是設計來改善病人的知識,以便對他們日後氣喘的狀況作出不同的影響。單純的增進病人的知識似乎並沒有減少住院治療,醫生訪問或使用藥物治療氣喘的比率,但可能對改善患者對其症狀的看法上發揮作用。然而,單單以病患教育方案來增進知識,就可以減少高風險的成人急診就診的比率。